Evaluation of efficacy and safety of apatinib treatment in advanced gastric cancer

Aim: We aimed to evaluate the efficacy and safety of apatinib treatment and its impact on the quality of life (QOL) of patients with advanced gastric cancer (GC) who experienced failure with at least two chemotherapeutic regimens. Materials and Methods: All patients received apatinib at a daily dose of 500 mg for 4 weeks per cycle until it was stopped due to disease progression, intolerable toxicity. Response Evaluation Criteria in Solid Tumors version 1.1 and Common Terminology Criteria for Adverse events 4.0 were used to assess tumor responses and toxicities, respectively. The European Organization for Research and Treatment of Cancer QLQ-C30 and QLQ-STO22 were used to assess the impact on patient's QOL. Results: Twenty-five patients were enrolled, but only 24 were evaluated for therapeutic effects. After apatinib treatment, none of the patients achieved complete response (CR), one achieved partial response (PR), and eight had stable disease (SD), resulting in a disease control rate of 37.5% (CR + PR + SD). Responses to questions regarding abdominal pain, nausea/vomiting, insomnia, constipation, and diarrhea in QLQ-C30 and abdominal pain and reflux in QLQ-STO22 were changed over the course of treatment (P < 0.05). The QOL score was elevated after three treatment cycles, but it was not considered statistically significant (P > 0.05). Conclusion: Results indicated that apatinib was effective in heavily pretreated patients with advanced GC who experienced failure with two or more line chemotherapies. The toxicities were tolerable or could be clinically controlled. Apatinib treatment alleviated some of the clinical symptoms but did not improve QOL significantly.

Health Literacy and associated factors among primary school students in Shandong province / 中国学校卫生

Objective@#To understand the status of health literacy and its associated factors among primary school students in Shandong Province.@*Methods@#By using stratified cluster sampling method, 9 063 children in grade 1 to 3 from 5 cities in Shandong Province were investigated with self-designed questionnaire. Chi square and multivariate logistic regression were used to analyze associated factors for health literacy.@*Results@#Rate of proficient health literacy among grade 1-3 primary school students was 62.8%(5 689/9 063), with 75.6%(6 850/9 063), 56.3%(5 106/9 063) and 80.1%(7 261/9 063) in dimension of safety emergency, health care and disease prevention and control. Proficient health literacy was 47.7%(4 327/9 063), 88.3%(8 003/9 063) and 73.6%(6 672/9 063) in domain of health knowledge and concept, health behavior and health skills. Univariate analysis showed that the health literacy varied by gender, only-child in the family, grade, living area, cities, self-perceived academic performance, father educational attainment, mother educational attainment, father occupation and mother occupation(χ2=39.66, 161.09, 193.05, 89.23, 1 107.75, 196.35, 99.43, 74.39, 64.86, 16.70, P<0.01). Multivariate analysis found that gender, only-child in the family, grade, living area, city, self-perceived academic performance, father’ s occupation and educational attainment were positively associated with health literacy among elementary students.@*Conclusion@#High level of health literacy has been found among primary school students in Shandong Province, but varied in area and different demographic characteristics, which needs further specific intervention.

Exercise and dietary behaviors among primary and middle school students in Shangdong Province and the related risk factors / 中国学校卫生

Objective@#To investigate knowledge, attitudes, and practice on exercise and dietary behaviors among the primary and middle school pupils in Shandong province, and to provide a theoretical basis for a targeted education on diet and physical health among the primary and middle school students.@*Methods@#A questionnaire survey was conducted among 6 161 students from 3 cities in Shandong province by random cluster sampling.@*Results@#Self-reported rate of having breakfast every day for primary and middle school students were 85.0% and 75.3% ,respectively(χ2=84.0，P<0.01). 41.2% of primary school students were reported to do physical exercises more than 60 minutes every day and the rate was only 29.6% for middle school students(χ2=270.0，P<0.01). 39.2% of boys were reported to do physical exercises more than 60 minutes every day and the rate was 28.7% for the girls(χ2=90.4，P<0.01). The awareness rates of knowledge about dietary and physical exercise among primary and middle school students were 44.4% and 55.8%, respectively(χ2=702.0，P<0.01). The awareness rates among boys and girls were 50.4% and 51.9% respectively (χ2=12.4，P<0.01). Parents’ occupation, knowledge score and education level of mother were influencing factors of breakfast behavior everyday. The physical exercise was influenced by gender, parents' occupation, knowledge score and education level of mother.@*Conclusion@#It is necessary to educate students to take healthy diet and have more physia1 activities. Families, schools and government departments need to take feasible measures to ensure the time and intensity of pupils’ physical exercise through many ways.

A study on population-based prenatal screening and diagnosis of Down's syndrome in Jiangsu province / 中华医学遗传学杂志

<p><b>OBJECTIVE</b>To screen and diagnose Down's syndrome during mid-term pregnancy to reduce the number of babies with Down's syndrome.</p><p><b>METHODS</b>With the multi-level of stratified cluster sampling, twenty thousand and eight hundred and three women at 15-20 weeks gestation were screened by maternal serum AFP and beta-hCG using the time resolved fluoroimmunoassay (TRFIA). Then the screened high-risk women were diagnosed by amniocentesis, cell culture and chromosome analyses. The born children were diagnosed by follow-up and peripheral blood chromosome analyses.</p><p><b>RESULTS</b>Six fetuses were diagnosed by serum screening and amniotic fluid chromosome analyses, and 3 born children were diagnosed by follow-up and peripheral blood chromosome analyses. Nine cases of Down's syndrome were detected in total, with the positive prenatal screen rate being 67% (6/9).</p><p><b>CONCLUSION</b>The prenatal screening and diagnosis can reduce the birth of Down's syndrome patients and improve the population quality. However, the diagnosis accuracy still needs to be improved to further reduce the false negative rate and prevent misdiagnosis.</p>

Long-term toxicity of Shen Yan Ling tablet and its effect on male reproductive function in rats / 中华男科学杂志

<p><b>OBJECTIVE</b>Shen Yan Ling Tablet is an innovative compound of traditional Chinese medicine, scientifically prepared with Tripterygium wilfordii, Radix Astragali, and others, with precise efficacy on renal diseases and reduced adverse effects of Tripterygium wilfordii. Based on the Guiding Principles for New Drug Toxicity Research Before Clinical Application, we investigated the long-term toxicity of Shen Yan Ling Tablet and its effect on the reproductive function in rats.</p><p><b>METHODS</b>According to the clinical therapeutic dose and the results of the acute toxicity test of Shen Yan Ling Tablet, we equally divided 80 rats (males and females half-and-half) into a low-dose (1.25 g/kg body wt), a medium-dose (2.50 g/kg body wt), a high-dose (5.00 g/kg body wt) and a control group. After a 3-month medication, we conducted standardized long-term toxicity tests and observed the effects of Shen Yan Ling on the serum sexual hormones and epididymal sperm count.</p><p><b>RESULTS</b>After 3 months of treatment with Shen Yan Ling, no death occurred, the general status remained unchanged, and the parameters of blood cytology and biochemistry fluctuated within the normal range, without any significant changes (P > 0.05). Some blood parameters, RBC, WBC, HGB, AST and TBIL, showed statistic changes (P < 0.05), but with no clinical significance. There were no significant differences in the mass coefficients of the main organs between the medication and control groups. The high-dose group exhibited slight hepatic and pulmonary pathological changes and significantly reduced sperm counts in the epididymis, but no significant changes in serum sexual hormones (P < 0.05).</p><p><b>CONCLUSION</b>Three-month medication of Shen Yan Ling at 1.25 - 5.00 g/kg produced no significant accumulated toxicity on rats, but it had a negative effect on their reproductive function at a higher dose of > or = 5.00 g/kg.</p>

Health investigation of 3 551 middle-aged and old males in Jiangsu Province / 中华男科学杂志

<p><b>OBJECTIVE</b>To understand the state of health of the middle-aged and old males in Jiangsu Province.</p><p><b>METHODS</b>A total number of 3 551 middle-aged and old males aged 46 approximately 69 years were randomly selected from 13 counties of Jiangsu Province. All of them received physical examinations, including laboratory tests of liver and kidney function, sugar and cholesterols, radioimmunoassay of testosterone and free testosterone levels in the serum, and B-ultrasonic examination of the prostate volume and remaining urine. They also underwent inquiries according to the International Index of Erectile Function (IIEF-5) and the questionnaire for PADAM (partial androgen deficiency of the aging male).</p><p><b>RESULTS</b>The prostate volume differed significantly (P < 0.05), while the testosterone level showed no significant difference in different age groups (P > 0.05). The level of the free testosterone in the serum descended with the increase of age. The incidence of ED and PADAM was also correlated with the increase of age.</p><p><b>CONCLUSION</b>In the old and middle-aged population of males, with the increase of age, sexual function decreases, the prostate volume enlarges, and the incidence of ED and PADAM obviously increases (P < 0.001).</p>

Effect of selective 5alpha-reductase inhibitor or/and testosterone undecanoate on the reproductive function of male rats / 中华男科学杂志

<p><b>OBJECTIVE</b>To investigate whether 5alpha-reductase inhibitor and dihydrotestosterone (DHT) play a role in spermatogenesis in male rats.</p><p><b>METHODS</b>Thirty-two male rats were divided into 4 groups (Groups C, T, F and FT). Group C received plant oil injection and oral starch perfusion, Group T testosterone undecanoate (TU, 20 mg/kg) injection and oral starch perfusion, Group F plant oil injection and oral Finasteride perfusion, and Group FT TU (20 mg/kg) injection and oral Finasteride perfusion. Data on serum T and DHT, sperm count, sperm mobility and reproductive function were collected and analysed.</p><p><b>RESULTS</b>(1) 5alpha-reductase inhibitor, Finasteride and TU reduced the weight of the testis and epididymis in the experiment groups compared with the negative control (Group C), but TU increased the weight of the prostate while Finasteride decreased it compared with the positive control (Group T). TU combined with Finasteride could counteract the effect of the weight increase of the prostate, but not that of the testis. (2) Finasteride, or Finasteride combined with TU, reduced the DHT but increased the testosterone level in comparison with the control group. (3) Both Finasteride and TU could inhibit epididymal sperm count and reproductive function compared with the control, but the effect was less significant in Group FT than in Group F.</p><p><b>CONCLUSION</b>High dosages of 5alpha-reductase inhibitor, Finasteride, can suppress male reproductive function, but the inhibiting effect could be counteracted by administration of 5alpha-reductase inhibitor along with TU.</p>

Effect of large-dosage of 5alpha-reductase inhibitors on the spermatogenesis of male rats / 中华男科学杂志

<p><b>OBJECTIVE</b>To identify the role of 5alpha-reductase in the spermatogenesis of male rats by studying the effect of two 5alpha-reductase inhibitors, Epristeride and Finasteride, on the spermatogenesis in male Sprague-Dawley (SD) rats.</p><p><b>METHODS</b>Changes in the weight of the testis, serum testosterone and dihydrotestosterone levels, epididymal sperm count, and reproductive function were observed and analyzed after the two 5alpha-reductase inhibitors were administered to male SD rats orally.</p><p><b>RESULTS</b>The experiment showed that in comparison with control animals, both the two 5alpha-reductase inhibitors: 1. suppressed the development of the prostate and reduced the weight of the testis in the experimental groups (P < 0.05); 2. decreased the serum level of dihydrotestosterone and enhanced testosterone; 3. inhibited epididymal sperm count and productive function.</p><p><b>CONCLUSION</b>High dosages of the 5alpha-reductase inhibitor, Epristeride, can suppress the development of the prostate and reduce the weight of the testis, decrease dihydrotestosterone, and inhibit spermatogenesis and productive function in male rats.</p>

Quantitative (stereological) study of incomplete spermatogenic suppression induced by testosterone undecanoate injection in rats / 亚洲男科学杂志(英文版)

<p><b>AIM</b>To evaluate the key lesions in spermatogenesis suppressed partially by testosterone undecanoate (TU) treatment.</p><p><b>METHODS</b>Adult male SD rats were treated with vehicle or TU (19 mg/kg) injection (i.m.) every 15 days for 130 days. The numbers of all types of cells (nuclei) in the seminiferous tubules and the interstitial tissue were estimated using a contemporary stereological tool, the optical disector.</p><p><b>RESULTS</b>In response to TU treatment, the numbers of non-type B spermatogonia, type B spermatogonia and late elongated spermatids per testis were reduced to 51 %, 66 % and 14 % of the controls, respectively. The conversion ratios from type B spermatogonia to early spermatocytes and pachytene spermatocytes were not significantly affected and the ratios to the later germ cell types fell to 51 % - 65 % of the controls. Less than 1.0 % of immature round spermatids were seen sloughing into the tubule lumen, 4.0 % of elongated spermatids retained in the seminiferous epithelium, and about half of the elongated spermatid nuclei appreciably malformed. Leydig cells were atrophied but their number and the peritubular myoid cell number per testis were unchanged.</p><p><b>CONCLUSION</b>Double inhibition of spermatogenesis (i.e. inhibition at spermiation and spermatogonial conversion to type B spermatogonia), a scenario seen in the monkey and human following gonadotrophin withdrawal, was not sufficiently effective for a complete spermatogenic suppression in the rat after TU treatment, probably due to ineffective inhibition of the Leydig cell population and therefore the intra-testicular testosterone levels.</p>

Effect of androgen on erythropoietin in patients with hypogonadism / 中华男科学杂志

<p><b>OBJECTIVES</b>To observe the change of erythropoietin (EPO) in patients of hypogonadism who received androgen replacement treatment and explore the mechanism of androgen-induced increase of red blood cells and haemoglobin.</p><p><b>METHODS</b>Eight patients with Klinefelter's syndrome, divided into two groups, received TU intramuscular injections of 500 mg or 1000 mg dose, respectively. After three months, seven patients received the second injection of crossover dose. Testosterone levels in serum were measured with RIA before and after the injections treatment. RBC count, impacted volume of blood cells and haemoglobin concentration were measured before treatment and 4, 8 weeks after treatment. At the same interval, EPO levels were measured with ELISA method.</p><p><b>RESULTS</b>Development of the secondary sex characters was improved in all patients after the TU injection. Serum testosterone levels raised significantly and reached the peak one week after the injections. Effective level of testosterone lasted for over 6 weeks. RBC count, impacted volume of blood cells and haemoglobin increased at different degrees after TU injections, but these changes were not significant in statistic(P < 0.05). The increased levels remained for 8 weeks. EPO levels were elevated significantly (P < 0.01 or 0.05) after the TU injection(Pbat > 0.05). The second injection could still make the EPO level go up.</p><p><b>CONCLUSIONS</b>Androgen replacement treatment can increase the EPO levels in patients of hypogonadism, which is one of the mechanism of RBC production increase.</p>

Studies and progress of male hormonal contraception / 中华男科学杂志

It has become more and more urgent to develop a safe, effective, recoverable and acceptable contraceptive for males. Decades of studies have made much progress on male hormonal contraception, one of the promising contraceptive methods. The principle is based on the suppression of pituitary gonadotropin and intratesticular testosterone, then the suppression of spermatogenesis, and the supplement of androgen to maintain the male characteristics and sexual function. There are many male hormonal contraceptive methods being studied include androgen, androgen combined with progesterone, GnRH antagonists combined with androgen, as well as immunological methods. To develop a safe and convenient androgen preparation with longer action and fewer side effects is also one of the key items of present research in this field.

Effect of MPA and MPA + TU on the rat spermatogenesis and sexual hormones / 中华男科学杂志

<p><b>OBJECTIVES</b>To investigate the effect of administration of MPA with/without TU on serum sexual hormones and spermatogenesis of male rats.</p><p><b>METHODS</b>Twenty rats had been classified into four groups. Each group received injection of saline(group A) or MPA(37.5 or 75 mg/kg) (group B or group C, respectively) or MPA (75 mg/kg) + TU (25 mg/kg) (group D) every month during three months. Data from serum sexual hormones (FSH, LH, T), sperm counting and motility had been collected and analysed.</p><p><b>RESULTS</b>Spermatogenesis of rats undergoing administration of MPA with or without TU had been suppressed. Serum FSH and LH of group B, C, D declined, and so did serum T of group D. Testis of rats of group D atrophied and sperm counting of group D decreased remarkably compared with group B and C. But there was no statistics difference of the sexual hormone level among group B, C and D.</p><p><b>CONCLUSIONS</b>Administration of MPA alone could suppress the levels of FSH and LH and block the spermatogenesis of male rats. MPA combined with TU could offer stronger suppression on spermatogenesis. Mechanism of the suppression on spermatogenesis of MPA + TU is not only limited in the feed-back of gonadotropin, but there maybe exist a direct suppression on testis.</p>

Study on the male contraceptive based on epididymis / 中华男科学杂志

More and more study on the epididymal function and sperm maturation has shown that epididymis will be one of the best target organs of male contraception, although at present there is not a male contraceptive medicine based on epididymis for clinical practice. The promoting research aspects in epididymal contraception in animal included affecting directly epididymis (such as Sulpasalazine), interfering energy metabolism and sperm mobility (such as Chlorinated Glycerol), altering the internal environment of epididymis (such as copper particles and TW19). The epididymal specific proteins could bring out some new target antigens for immunological contraception, to produce contraceptive vaccine. Some special genes, which expressed distinctively in epididymis such as SC342, bin1, have been cloned and studied on their function. These works would be helpful not only for clinical diagnosis and treatment of epididymitis and male infertility, but also for male contraceptive research and progress.